Bipolar Disorder
Bipolar
The diagnosis of Bipolar Disorder had always been controversial. It had always relied on self-reported symptoms or more often from friend and families who find the touchy behavioral symptoms. Bipolar disorder which is also known as manic-depressive illness is a brain disorder that can cause unusual shifts in a person’s mood, energy, and ability to function. It is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood (National Institutes of Mental Health [NIMH], 2008).
Individuals who experience manic episodes can also experience depressive episodes, or mixed episodes in which features of both mania and depression are present at the same time. It can cause dramatic mood swings, from overly high and irritable to sad and hopeless, and then back again, often with periods of normal mood in between (NIMH, 2008). There may also be severe changes in energy and behavior that go along with these changes in mood and the periods of highs and lows are called episodes of mania and depression (NIMH, 2008).
Definition
As specify in the DSM-IV-TR manual, the different diagnostic definition of bipolar category are as follows.
An individual with the disease, Bipolar I, will have experience one or more manic episodes with or without major depressive episodes.
Bipolar II is characterized by the occurrence of least one episode of depression and at least one hypomania episode. A mild to moderate level of mania is called hypomania.
Cyclothymia is a mild form of bipolar disorder. Cyclothymia includes mood swings but the highs and lows are not as severe as those of full-blown bipolar disorder. The onset of Cyclothymia requires experience with several episodes of hypomania, mixed with depressive episodes that do not meet full criteria for major depressive episodes.
Individual who do not meet any of the criteria of the above will receive a diagnosis of Bipolar Disorder NOS.
Bipolar complications
The same as with any mental illness, bipolar disorder has its consequences in all aspects of a person’s life. Found here are resources and information relating to the social issues raised by the disorder.
According to Geller and Luby in 1997, both children and adolescents can develop bipolar disorder and it is more likely to affect the children of parents who have the illness, suggesting genetic influence. Also, mixed symptoms are common in youths with bipolar disorder. Older adolescents who develop the illness may have more classic, adult-type episodes and symptoms such as suicide, alcoholism, and drug abuse.
Mortality rate of individuals with Bipolar were found to be higher than general population with suicide as the main cause (Astrup et al., 1959, Tsuang et al., 1980). Another reason for the high mortality could be that too little attention is given to the physical health of patients with the psychiatric disease, and that diagnosis of physical symptoms are attributed to the psychiatric illness or to psychological distress by the patients as well as the doctors (Hall et al., 1978; Koranyi, 1979).
Poor self-care such as poor nutrition and inactive lifestyle were reported during episodes and could indirectly compromise general health and contribute to the elevated mortality rates. Smoking and alcohol abuse are also associated with the increased mortality (Goodwin & Jamison, 1990). Greater frequency of heavy smoking has also been reported in patients relative to the general population (Hughes et al., 1986; Tanskanen et al., 1997).
Treatment
Bipolar are usually treated with pharmacotherapy in conjunction with psychotherapy. It is a recurrent disorder that needs a long-term prevention type treatment that combines medication with psychotherapy (National Institute for Health and Clinical Excellence).
Lithium is the first mood stabilizing medication approved by U.S. FDA to treat bipolar. According to the National Guideline Clearinghouse (NGC), Lithium is the first line medication. Therapy with Lithium only should be sufficient for the less ill patients, but for many others a combination with anticonvulsant or antipsychotic medication may be needed (NGC).
In addition to medication, psychotherapy is an effective treatment that provides support, education, guidance and help for those that suffer from bipolar disorder and their families. Usually, this type of treatment focuses on adjusting to life problems caused by the disorder, identifying the onset of both types of episodes maniac and depressive, developing functional responses, and helping the person to accept, cope, and manage the disorder. This may include Cognitive behavioral therapy, Psychoeducation, Family therapy, and Interpersonal and social rhythm therapy (Nervenarzt, 2007).
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